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Test ID VZIKM Zika Virus, IgM Antibody Capture ELISA, Serum


Ordering Guidance


For specimens collected less than 14 days post-symptom onset or possible Zika virus exposure, reverse transcription polymerase chain reaction testing for Zika virus using serum and urine is recommended to exclude a false-negative Zika virus IgM result. For more information see RZIKU / Zika Virus, PCR, Molecular Detection, Random, Urine and RZIKS / Zika Virus, PCR, Molecular Detection, Serum.



Additional Testing Requirements


This is a screening test for Zika virus. As required by your local health department, confirmatory testing of a presumptive positive result may be necessary.

 

Due to similar clinical presentation and cross reactivity, testing for IgM-class antibodies to dengue virus is recommended to occur concurrently with Zika virus IgM testing. Order DENVP / Dengue Virus Antibody/Antigen Panel, Serum.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Allow blood to clot at room temperature (20-25° C) for 30 to 60 minutes, then centrifuge and aliquot serum into plastic vial.

2. Send serum specimen frozen.


Secondary ID

618559

Useful For

Screening for the presence of IgM-class antibodies to Zika virus

 

This test is not intended for medical-legal use.

 

This test is not recommended for asymptomatic couples attempting conception.

Method Name

IgM Antibody Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA)

Reporting Name

Zika Virus MAC-ELISA, IgM, S

Specimen Type

Serum

Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Frozen 30 days

Clinical Information

Zika virus is an RNA virus in the genus Flavivirus and is primarily transmitted through the bite of an infected Aedes species mosquito. Other means of transmission include through transfusion of blood and blood products, sexually through genital secretions, perinatally, vertically from mother to fetus, and potentially through contact with other body secretions such as tears and sweat.

 

Historically, most cases of Zika virus infection have occurred in parts of Africa and South-East Asia. However, Zika virus emerged in South America in early 2015 and is now endemic in over 50 countries in South, Central, and North America, including in several US territories and focal regions of the southern United States.

 

The majority (approximately 80%) of individuals infected with Zika virus are asymptomatic. Among symptomatic patients, fever, headache, retro-orbital pain, conjunctivitis, maculopapular rash, myalgias, and arthralgias are commonly reported. Notably, these symptoms are not distinct and can be seen with other emerging arboviruses, including dengue and chikungunya. Therefore, diagnostic testing for each of these viruses is recommended in patients returning for areas where these viruses cocirculate. Intrauterine or prenatal infection with Zika virus has been causally linked to development of microcephaly, with the greatest risk for fetal abnormality occurring if the infection is acquired during the first trimester. Finally, Zika virus has also been associated with development of Guillain-Barre syndrome.

 

A number of Zika virus serologic and nucleic acid amplification tests have received emergency use authorization through the US Food and Drug Administration. The recommended tests vary by the patient's symptoms, course of illness, and whether the patient is pregnant.

 

For the most up-to-date information regarding Centers for Disease Control and Prevention testing guidelines, visit www.cdc.gov/zika/.

 

These guidelines are reflected in Assessment for Zika Virus Infection.

 

Zika virus testing is not recommended for asymptomatic couples attempting conception, given the potential for false-positive and false-negative results. Additionally, it is well established the Zika virus may remain in reproductive fluids, despite negative serologic and molecular test results in blood and urine.

Reference Values

Negative

Cautions

A presumptive positive result by this test only suggests infection with Zika virus. This result should not be considered as diagnostic for Zika virus infection. False-positive results may occur in patients infected with other, closely related flaviviruses, including dengue virus, or in patients who have been vaccinated against yellow fever virus. Only limited evaluation of cross-reactivity with flaviviruses or arboviruses has been conducted. Therefore, confirmatory testing of presumptive or possible positive samples may be required and should be performed as determined by the local health department. Evaluation of sample by real-time polymerase chain reaction for Zika virus may also be warranted.

 

False-negative results can arise from specimen collection prior to development of an IgM antibody response (less than 4 days post-symptom onset) or after IgM levels have decreased below detectable levels. Negative results from at-risk individuals who are immunosuppressed should be interpreted with caution.

 

Negative results do not preclude infection with Zika virus and should not be used as the sole basis of patient treatment or management decisions. All results should be interpreted by a trained professional in conjunction with review of the patient's exposure history and clinical signs and symptoms.

 

Zika and dengue virus infections presents with symptoms similar to other arboviruses that cocirculate in areas where Zika virus is currently endemic. Diagnostic testing to rule out these infections (eg, chikungunya) and other similar presenting infection should be considered.

 

Testing of asymptomatic pregnant women with possible exposure, but without ongoing exposure to Zika virus, is not routinely recommended.

Day(s) Performed

Bimonthly on the first and third Wednesday; fifth Wednesday when applicable

Report Available

Same day/1 to 14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86794

NY State Approved

Yes